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The Making of Medicine

Easier Blood-Sugar Monitoring for Patients on Dialysis

People on dialysis can suffer dangerous swings in their blood-sugar levels. But a new study from our Meaghan M. Stumpf, MD, suggests that a factory-calibrated continuous glucose monitor may be able to help.

Dr. Stumpf's study, believed to be the first of its kind, tested the Dexcom G6-Pro continuous glucose monitor to determine if it was sufficiently accurate for use by patients on dialysis and those suffering end-stage renal disease [ESRD]. Such monitors are widely used by patients with diabetes, but there has been a lack of information on whether a factory-calibrated monitor would be sufficiently accurate for patients on dialysis.

To find out, Dr. Stumpf and her team put the Dexcom monitor to a test in a trial with 40 volunteers. Participants were asked to wear the monitor for 10 days and take four to seven fingerstick blood-sugar readings per day with a home glucometer. Blood samples were also collected during their hemodialysis sessions.

The researchers then compared the CGM glucose results with the blood-sample results. Based on that, Stumpf and her team determined that the Dexcom device showed “clinical reliability” -- meaning it was sufficiently accurate for estimating blood-sugar levels for patients on dialysis. Almost 99% of the readings were accurate enough to be used without confirmatory fingerstick blood-sugar readings.

One caveat: When the devices erred, they tended to overestimate blood-sugar levels. Considering that people on dialysis tend to be at risk for low blood sugar, the researchers say additional research is warranted. But Dr. Stumpf says the overall results are promising.

"Our research team conducted this pilot study so that we could begin to understand the accuracy of these devices for patients with ESRD on hemodialysis," she said. "This study is not large enough to lead to FDA approval, but it is important to take the first step.”

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